Category: Infectious Disease and Oncology Medications

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Abacavir Pharmacology

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Abacavir is a nucleoside reverse transcriptase inhibitor used in the management of HIV.

In patients who have the HLA-B*5701 allele, they are at much greater risk for hypersensitivity reactions.

Lactic acidosis and hepatomegaly are potential complications with the use of abacavir.

While abacavir is not known for a large number of drug interactions, I discuss a few that you have a chance to run into.

I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.

Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!

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Fosfomycin Pharmacology

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Fosfomycin is an antibacterial agents that can be utilized in the management of uncomplicated UTIs.

Uniquely, fosfomycin comes as a packet that needs to be mixed with COOL water. I discuss this further on the podcast.

Typhoid and Cholera vaccine effectiveness may be reduced when used with fosfomycin.

When there is kidney or systemic infection involvement, it is recommended to avoid the use of fosfomycin.

I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.

Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!

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Terbinafine Pharmacology

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Terbinafine can inhibit CYP2D6 which plays an important role in the metabolism of many drugs such as metoprolol, fluoxetine, and clozapine.

With terbinafine’s ability to inhibit CYP2D6, it can also increase the risk of treatment failure with drugs like tamoxifen.

When using anti-fungal drugs like terbinafine, remember that fungal infections can often require more time to treat.

Terbinafine has the potential to cause liver impairment. I discuss this further on the podcast.

I discuss important drug interactions on the podcast, be sure to check out my latest project which is a 200+ page book on managing drug interactions in primary care.

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Metronidazole Pharmacology

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Metronidazole (Flagyl) is an antibiotic that is used for various infections.

Metronidazole can certainly cause GI upset like most antibiotics, but uniquely may also cause a metallic taste.

Metronidazole is also rarely associated with CNS changes and can induce the potential for peripheral neuropathy.

Patients should avoid alcohol with the use of metronidazole and this is on account for the possibility of a disulfiram reaction. I discuss some of the symptoms of this reaction in the podcast.

Metronidazole can substantially raise the concentrations of warfarin. INR monitor and a reduction in dose of warfarin may be necessary.

Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!

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Erythromycin Pharmacology

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Erythromycin uniquely has some potential benefit in the setting of gastroparesis. Azithromycin you will likely not see used for this indication.

Erythromycin binds the 50s subunit and ultimately prevents protein synthesis which is necessary for bacteria to grow and replicate.

QTc prolongation is a risk with all macrolide antibiotics (erythromycin included).

By inhibiting CYP3A4, erythromycin can be responsible for numerous drug interactions.

Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!

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Acyclovir Pharmacology

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On this episode “Acyclovir Pharmacology” I discuss the mechanism of action, important monitoring parameters, and drug interactions with acyclovir.

I discuss why acyclovir has to be dosed so many times per day.

Acyclovir can inhibit CYP1A2 which can impact a few drugs. I discuss a couple of those examples on this podcast episode.

GI effects are one of the more common side effects of acyclovir.

Rarely, neuropathy and nephropathy can be part of the adverse effect profile of acyclovir. I discuss this further on this episode.

Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!

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Oseltamivir Pharmacology

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Oseltamivir is an antiviral agent that is indicated for the treatment and prophylaxis of influenza.

It is important to remember that oseltamivir is cleared at least in part by the kidney and dose adjustments should be made based upon kidney function.

There is a low potential that oseltamivir could contribute to psych issues like delirium.

Probenecid has the potential to raise the concentrations of oseltamivir.

Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!

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Dolutegravir

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Dolutegravir is an integrase inhibitor that is used in the management of HIV infection/

Carbamazepine along with other enzyme inducers can substantially lower the concentrations of dolutegravir.

Dolutegravir can potentially increase blood sugars, this should be closely monitored in our patients with diabetes.

CNS adverse effects like insomnia and dizziness can happen with dolutegravir.

Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!

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Rifampin Pharmacology

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Rifampin is classified as an antibiotic and an antituberculosis agent. It primarily works by inhibiting bacterial RNA polymerase.

While not extremely common, rifampin is well known to cause hepatic dysfunction.

You should remind patients who are taking rifampin that it can alter the color of tears, sweat, saliva and urine. It can change these fluids to a reddish/brown color.

Rifampin is very well known for causing drug interactions. It is an enzyme inducer that can reduce the concentrations of numerous medications such as warfarin, apixaban, cyclosporin, levothyroxine, and oral contraceptives to name a few.

Rifampin can be used to help prevent meningococcal infection. Learn more on rifampin by listening to this podcast!

Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!

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Azithromycin Pharmacology

Azithromycin Pharmacology

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On this episode, I cover azithromycin pharmacology. This drug primarily acts by inhibiting protein synthesis. It binds to the 50s ribosomal subunit.

GI adverse effects like nausea and diarrhea are going to be the most common with azithromycin.

Azithromycin has been associated with prolonging the QT interval. Drugs like amiodarone, ondansetron, citalopram, antipsychotics, and quinolone antibiotics can also prolong the QT interval.

One major advantage that azithromycin has over other antibiotics is that it has a long half life which allows for once daily dosing.

Azithromycin has numerous uses like pneumonia, MAC, alternative for ear infections in patients with a beta-lactam allergy, certain STD’s, and also is rarely used in long term COPD exacerbation prevention.

Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!